Monday, July 16, 2012

SAMHSA Aligned with Managed Care

When you have been as sensitized as I have to the rebranding of
mental health services as "behavioral health" by the
managed care industry - seeing a government agency promoting that brand is
difficult to take. I got ane-mailfrom SAMHSA
this morning that does exactly that. The subsequent spin
on behavioral health and health care reform needs to be read to be
believed. It is something that only a government bureaucrat or managed
care administrator could actually believe.

This is an interesting excerpt: "Twenty years
ago, even some in the behavioral health field didn't think recovery was
possible." Maybe that was why they were telling me that people in
the throes of detoxification were now stable after three days. Insisting
that subscribers to their managed care insurance should be discharged home and
that they could go to outpatient treatment despite repeated failures is
certainly consistent with that statement.

Their spin on the PPACA is even more incredible with this
summary statement: "Providers will also face new payment mechanisms such
as capitation, episode rates, and team based payments rather than based on
services provided." That statement alone is proof that nobody at
SAMHSA seems to understand that capitation was the primary mechanism that
managed care used to dismantle mental health and addiction services to the abysmal
level that they currently exist at. Either that or they understand
perfectly.

This web page confirms what I have been saying for the past
twenty years. The government, in this case the federal government has
been colluding with the managed care industry to marginalize the
expertise of professionals and to continue to disproportionately ration care to
anyone with a mental illness or an addiction. The managed care industry and
federal and state governments can spin that anyway that they want, but they
can't get rid of the dismal record of the past 20 years or the fact that the government is now obviously promoting it.